In those cases in which a man has a  blockage (non-surgically correctable) that prevents the sperm to reach the semen, several options still exist for sperm retrieval that may be utilized in combination with assisted reproductive techniques (ART), including  in vitro fertilization (IVF), to successfully achieve a pregnancy. Sperm retrieval may be accomplished via several options including percutaneous epididymal sperm aspiration (PESA) where aspiration is performed from the epididymis (the anatomic structure connecting the testicle to the vas deferens), microsurgical epididymal sperm aspiration (MESA), testicular sperm aspiration (TESA) aspirating sperm directly from the testicle, and testicular sperm extraction (TESE).  Dr. Parviz Kavoussi will most commonly perform PESE or TESE in the operative suite adjacent to the IVF lab at Westlake IVF with the embryologist evaluating the sperm at the time of sperm retrieval.